de Zwaan M, Nutzinger D O, Schoenbeck G
Department of Psychiatry, University of Vienna, Austria.
Compr Psychiatry. 1992 Jul-Aug;33(4):256-61. doi: 10.1016/0010-440x(92)90050-z.
Data on the prevalence and characteristics of binge eating in a series of 64 obese women participating in a controlled weight-reduction program are presented. Twenty-two (34.4%) reported recurrent binge eating episodes defined as overeating plus loss of control as assessed by patients' self-report and confirmed by a clinical interview. Six of those indicated that they engaged in either self-induced vomiting or laxative use to control their weight, but only two met full criteria for current bulimia nervosa according to DSM-III-R. A detailed description of the binge eating behavior revealed similarities to the eating pattern described in patients with bulimia nervosa: obese binge eaters tended to overeat in the evening, when they were alone and at home. Compared with their non-binge eating counterparts, binge eaters were significantly younger when they presented for treatment. The prevalence of childhood obesity was higher, and they were significantly younger when they first started on a diet than the non-binge eaters. Binge eaters reported more psychological problems such as body image distortion, and there was a slight tendency for binge eaters to exhibit more depressive symptomatology at baseline. No association between binge eating and weight at baseline, or weight loss during therapy or at follow-up could be found. Fluvoxamine (100 mg) did not seem to be of specific benefit in this subgroup of the obese with regard to weight loss.
本文呈现了64名参与控制体重减轻计划的肥胖女性中暴饮暴食的患病率及特征数据。22名（34.4%）报告有反复的暴饮暴食发作，根据患者自我报告并经临床访谈确认，暴饮暴食定义为过度进食加失控。其中6人表示他们采用自我催吐或使用泻药来控制体重，但根据《精神疾病诊断与统计手册》第三版修订版（DSM-III-R），只有2人符合当前神经性贪食症的全部标准。对暴饮暴食行为的详细描述显示，其与神经性贪食症患者所描述的饮食模式相似：肥胖的暴饮暴食者倾向于在晚上独自在家时过度进食。与非暴饮暴食的同龄人相比，暴饮暴食者在接受治疗时明显更年轻。儿童期肥胖的患病率更高，并且他们首次开始节食时的年龄比非暴饮暴食者明显更小。暴饮暴食者报告有更多心理问题，如身体形象扭曲，并且在基线时暴饮暴食者有轻微的倾向表现出更多的抑郁症状。未发现暴饮暴食与基线体重、治疗期间或随访时的体重减轻之间存在关联。氟伏沙明（100毫克）在该肥胖亚组中似乎对体重减轻没有特别的益处。
